Effects on Health / Economy

Why do people begin to smoke?

Most people begin smoking as teens, generally because of peer pressure and curiosity. Also, people with friends and/or parents who smoke are more likely to take up smoking than those who don't.

Another prevalent influence in our society is the tobacco industry's ads and other promotional activities for its products. The tobacco industry spends billions of dollars each year to create and market ads that show smoking as an exciting, glamorous, and healthy adult activity.

How does cigarette smoke affect the lungs?

All cigarette smokers have a lower level of lung function than nonsmokers. Cigarette smoking causes several lung diseases that can be just as dangerous as lung cancer. Chronic bronchitis-a disease where the airways produce excess mucus, which forces the smoker to cough more often...is a common ailment of smokers.

Cigarette smoking is also the major cause of emphysema-a disease that slowly destroys a person's ability to breathe. For oxygen to reach the blood, it must move across large surfaces in the lungs. Normally, thousands of tiny sacs make up the surface area in the lungs. When emphysema occurs, the walls between the sacs break down and create larger but fewer sacs. This decreases the amount of oxygen reaching the blood. Eventually, the lung surface area can become so small that a person with emphysema often must gasp for breath. In later stages of the disease, patients must keep an oxygen bottle nearby or breathe with the help of oxygen tubes inserted into the nose.

More than 7 million current and former smokers suffer from chronic obstructive pulmonary disease (COPD), the name used to describe both chronic bronchitis and emphysema. Often both of these conditions are present at the same time. The late stage of chronic lung disease is one of the most miserable of all medical conditions. It creates a feeling of gasping for breath all the time...similar to the feeling of drowning.

Why do smokers have "smoker's cough?"

Cigarette smoke contains chemicals that irritate the air passages and lungs. When a smoker inhales these substances, the body tries to protect itself by producing mucus and coughing. The "early morning" cough of smokers happens for several reasons. Normally, tiny hair-like formations (called cilia) beat outward and sweep harmful material out of the lungs. Cigarette smoke slows the sweeping action, so some of the poisons in the smoke remain in the lungs and mucus remains in the airways. When a smoker sleeps, some cilia recover and begin working again. After waking up, the smoker coughs because the lungs are trying to clear away the poisons that built up the previous day. The cilia stop working after long-term exposure to smoke. Then the smoker's lungs are even more exposed and susceptible than before, especially to bacteria and viruses in the air.

How does tobacco use affect the economy?

The tobacco industry is one of the most profitable businesses in the country, making billions of dollars yearly. But the costs of smoking are far higher than the income from cigarette sales. Smoking causes more than $167 billion each year in health-related costs, including the cost of lost productivity due to smoking.

  • Smoking-related medical costs totaled more than $75 billion in 1998 and accounted for 8% of personal health care medical expenditures.  
  • Death-related productivity losses due to smoking among workers cost the US economy more than $92 billion yearly (average for 1997-2001).  
  • For each pack of cigarettes sold in 1999, $3.45 was spent on medical care due to smoking, plus $3.73 in lost productivity, for a total cost of $7.18 per pack.

 Medical Consequences of Smoking

The list of medical and health effects of smoking is long and well known and can be divided into short-term or immediate effects of smoking and long-term or chronic effects.

At the first puff, nicotine enters the lungs, crossing from the alveoli directly into the bloodstream. Within about 10 seconds of the first inhalation, nicotine has reached the brain. By 15 to 20 seconds, nicotine has traveled throughout the body. Nicotine is distributed to all body tissues. It can even be found in the freshly washed hair of long-term smokers. The drug is picked up rapidly by the cells and within a short time after smoking, little of the drug is found in the bloodstream. Once in the body, nicotine is broken down primarily by the liver but also by the lungs into cotinine and nicotine oxide. The kidney then excretes these metabolites.

Immediate Effects of Smoking

  • The immediate effects of smoking are an increase in heart rate, blood pressure and respiration, and a decrease in skin temperature due to a constriction or closing of peripheral blood vessels. Nicotine and carbon monoxide are primarily responsible for these effects through the stimulation of a rapid release of adrenaline, the "fight or flight" hormone.
  • The first cigarette of the day (as well as the first cigarette ever) may be accompanied by nausea and diarrhea, also due to the nicotine inhaled.
  • With each cigarette smoked, the levels of nicotine and its by-products increase. Significant levels of nicotine remain in the body throughout the night, with the result that by the next morning, blood levels are low and the addicted smoker craves a cigarette to replenish blood levels.
  • Nicotine is biphasic:  that means it has two different effects based on the amount of nicotine ingested. In small doses, nicotine is a stimulant, mimicking the effect of acetylcholine, a neurotransmitter that transmits information from nerve cells to muscle cells. In large doses, nicotine is a sedative and can be toxic. Large doses of nicotine were once used to sedate elephants for capture.

 

Long-Term Effects of Smoking

  • The long-term effects of cigarette smoking are primarily associated with the respiratory and cardiovascular systems.
  • Smoking is the main cause of lung cancer and is associated with 90 percent of all lung cancers.
  • Smoking can also cause bronchitis, emphysema and an increase of asthma in children and adults.
  • The relationship between cigarettes and coronary heart disease was established in the 1940s. Smokers have a 70 percent higher rate of coronary heart disease, twice the risk of heart attack and five times the risk of stroke as non-smokers.
  • Smoking substantially increases the risk of heart disease, including stroke, heart attack, vascular disease and aneurysm. Because nicotine is present in the body throughout the day, the heart is constantly stimulated to work faster. This increased demand on the heart combines with altered lipid metabolism to increase the likelihood of the development of atherosclerosis.
  • Smoking is also associated with over 30 percent of all cancer deaths. Smoking has been implicated in cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, uterus and bladder.
  • There are a number of physical changes associated with smoking. Tar in cigarette smoke turns teeth and fingernails yellow. The chemical components of tobacco smoke can be found in the hair and skin of smokers.
  • In humans, large doses of nicotine cause sedation of the respiratory system. At higher doses, such as the nicotine used in insecticide sprays, nicotine can cause vomiting, tremors, convulsions and death. Accidental ingestion of tobacco products by children and dogs results in nicotine poisoning which may result in death by respiratoryparalysis.

 Environmental Tobacco Smoke

Indirectly, environmental tobacco smoke accounts for approximately 3,000 lung cancer deaths per year and contributes to as many as 45,000 deaths related to cardiovascular disease.

Environmental tobacco smoke has also been associated with sudden infant death syndrome (SIDS). Additionally, cigarettes are the leading cause of residential fire fatalities, leading to more than 1,000 such deaths each year